I think I'm going to counter the "don't be political crowd" with "politics should stop getting scientific!"

@load-dependent.eurosky.social @schistosomnia.bsky.social important to note we have been down this road repeatedly in the past.... Filtration of some sort always come back into vogue, promising "this time it's different" then eventually shows worse outcomes. I doubt this time is any different.

And yep, totally agree on this one. 3-5d of ceftriaxone is probably sufficient for more cases.

Smoldering infections tend to give way to higher cancer risk. Not sure if it's been demonstrated with GU Chlamydia, but just about everywhere else we've looked that seems to be the case.

Interesting debate points though.

Wonder if there is a role in target vaccination for people at risk of deep space infections like ESRD or IVDA 🤔

I cut back on avocado toast and gas was still $5.85 in CA 😞

@ventwhisperer.bsky.social nice work on the papers!

Rec a few:
Ventibrain and prolabi suggest 8cc/kg better for neuro pts
Patch trial on platelets in ich
Prophyvap for intubated neuro pts

The sick patient that needs surgery....

Gets sicker, and still needs surgery.

Legionella Pneumonia in the Modern Era: Clinical Features and Predictors of Mortality This multicenter cohort study characterizes contemporary Legionella pneumonia, demonstrating substantial critical illness and mortality. Age, cirrhosis, ly

academic.oup.com/cid/advance-...
Or
(Slightly older)
www.nejm.org/doi/abs/10.1...

Effect of High PEEP vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients This randomized trial compares the effects of higher levels of positive end-expiratory pressure (PEEP) with alveolar recruitment maneuvers vs a lower level of PEEP on postoperative respiratory failure...

Idk ... Seems like PEEP for obesity is still open for debate.

Plus Most higher peep for obese pts in COVID we're a mixed bag- no mortality benefit, but traded renal dysfunction for a few less MV days.

jamanetwork.com/journals/jam...

Secondary outcomes not terrible, and might be some inkling of benefit if you strain hard enough. I'm an albumin hater too, but this study doesn't immediately make me shut down others trying to use it (unfortunately)

Small correction - it's pyxis not pixis 😇

Tend to agree with raj.

I've said since early twitter that push dose pressors are a sign of an ill prepared department - just run norepi since you're likely going to need it anyway if you're pushing phenyl or epi.

Anecdotally agree with RSI paper- see more hypoTN w/ K + doesnt seem dose dependent

Narcissism + desire to be unique = conspiracy beliefs.

Yep, that fits.

Study: "...national narcissism is related to group-attributed need for uniqueness that goes hand in hand with conspiracy beliefs..."

MORE organ failure with VitC. Yuck.

Sadly, early rehab continues to be labor intensive with questionable returns.

A "JAMA" article, published online December 3, 2025, titled "Universal Hepatitis B Vaccination at Birth—Risks of Revising the Recommendation" by Michael S. Abers et al., discusses ACIP's review and a possible vote to eliminate the birth dose recommendation.

💬Viewpoint: Eliminating universal hepatitis B birth dose vaccination risks an estimated 8% increase in annual perinatal #HepatitisB infections in the US, increasing preventable chronic disease burden. ja.ma/3Me0zHh

Anyone happen to have a clip for teaching purposes of an aortic dissection... That's caught while trying to find the gall bladder? #POCUSsky

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Ceftriaxone to prevent early ventilator-associated pneumonia in patients with acute brain injury: a multicentre, randomised, double-blind, placebo-controlled, assessor-masked superiority trial - PubMed French Ministry of Social Affairs and Health.

And throw in a dose of ceftriaxone....

pubmed.ncbi.nlm.nih.gov/38262428/

Not sure what to take away from said trial, except *maaaaaybeeee* there's an signal of "dont miss sepsis induced cardiomyopathy" as evidenced by giving more inotropy/dobutamine in CRT arm.

I'm slightly concerned bicar2 is going to push a lot more bicarb drips to save a few HD days....

Teaching machines the language of biology: Scaling large language models for next-generation single-cell analysis

@albertvilella.bsky.social how does Google's offering affect 10x Genomics, it at all?

Possibly help by increased awareness/curiosity? Is there a chance it pulls business away eventually?

research.google/blog/teachin...

Effectiveness of Ampicillin-Sulbactam Versus Ceftriaxone for the Initial Treatment of Community-Acquired Pneumonia in Older Adults: A Target Trial Emulation Study - PubMed In older patients with CAP, initial treatment with ampicillin-sulbactam was associated with higher mortality compared to treatment with ceftriaxone.

Plus there's this ....

pubmed.ncbi.nlm.nih.gov/40134633/

Staph aureus bacteremia

Thoughts on nuc med studies for SAB? Thought there was supposed to be a multi center trial out of Europe due last year but not published yet....

Seems like it might be a "you pick up more, but doesn't seem to matter much/doesn't frequently change management" scenario?

Yep. Still, ICU patients that find it beneficial for pain control are the exception. Overwhelming majority of patients we've had on it more often find it deleterious than helpful. This study kind of confirms that bias.

Putting pts in a partial K hole is probably a suboptimal idea in the ICU. Tubes and lines in weird places + delirium+ drawing labs = whoa buddy.

Over last few years, have started to feel ketamine for pain probably a rescue tactic at best. Lots of better options.

If I can't block, precedex >>>> ketamine for pain control.

journals.lww.com/anesthesia-a...

#EMIMCC

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